Productivity improvements in work environments are increasingly based upon creative tasks that involve less physical activity and greater use of an individual's cognitive abilities. The changing nature of work is one of the causes of work-related stress and an increasingly sedentary lifestyle. With changes in dietary intake and lifestyle over a period of time (e.g. a growing preference towards conveniently pre-packaged foods, snacks and fast foods), individuals are exposed to greater risks of developing disease conditions of the mind and body that, if uncontrolled, may have a more significant impact on communities than that of HIV/AIDS in terms of morbidity and mortality.
Work-related stress is often associated with organisations in the context of the social/time pressures and uncertainty as a consequence of changes in the workplace (e.g. downsizing, upsizing and mergers and acquisitions of companies) aimed at improving productivity and efficiency of the business for survival (as discussed in Pfeffer J., The human equation, 1998, Harvard Business School Press, Boston, Mass.; and Vahtera J. et al., Effect of organizational downsizing on health of employees, Lancet 1997, 350, pp. 1124-28; and Westerland H. et al., Workplace expansion, long-term sickness, and hospital admission, Lancet, 2004, 363, pp. 1193-97). The challenge is to handle necessary organizational changes to adapt to an increasingly competitive business environment without imposing significant health risks on the workforce to the point where work performance is adversely affected (as discussed in Arnetz B. B., Subjective indicators as a gauge for improving organizational well-being—An attempt to apply the cognitive activation theory to organizations, Psychoneuroendocrinology, 2005, 30, pp. 1022-26). A healthy organisation can be defined in terms of both financial success and a work force with few health-related problems (as discussed in Saintfort F. et al, Applying quality improvement principles to achieve healthy work organizations, Jt. Comm. J. Qual. Improv., 2004, 27, pp. 469-83). This definition is consistent with the expectations of modern society and the established link between workplace absenteeism due to health-related issues and lost workplace productivity (as discussed in McDaid D., Curran C., Knapp M., Promoting mental well-being in the workplace: A European policy perspective, Int. Rev. Psychiatry., 2005, 17(5), pp. 365-73). Studies on work-reward balance have shown the need to maintain appropriate social reciprocity in order to avoid the risk of stress-related disorders. Besides the economic burden of work-related stress disorders, research suggests that the burden on individuals who experience failed reciprocity at work are twice as likely to suffer from incident cardiovascular disease, depression or alcohol dependence compared to those who are not exposed (as discussed in Siegrist J., Social reciprocity and health: New scientific evidence and policy implications, Psychoneuroendocrinology, 2005, 30, pp. 1033-38). It is therefore important to avoid and/or reduce work-related stress in an individual when aiming to improve their overall health and well-being.
A less recognised disease condition of the body is metabolic syndrome, which is characterised by the clustering of abdominal obesity, dyslipidemia, hyperglycemia and hypertension, and which has been cited as a major public health challenge worldwide (as discussed in Eckel R H, Grundy S M, Zimmet P X., The metabolic syndrome, Lancet, 2005, 365, pp. 1415-1428). Metabolic syndrome is associated with a 5-fold increase in the risk of type-2 diabetes and a 2-fold to 3-fold increase in the risk of cardiovascular disease. Research suggests that the economic burden from metabolic syndrome is significant and rising supported by recent estimates from Australia and the US indicating that 20-25 percent of the adult population have the syndrome (as discussed in Dunstan D W, Zimmet P Z, Welborn T A et al., The rising prevalence of diabetes and impaired glucose tolerance, The Australian Diabetes, Obesity and Lifestyle Study, Diabetes Care, 2002, 25, pp. 829-34; and Ford E S, Giles W H, Dietz W H., Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey, JAMA, 2002, 287(3), pp. 356-9).
Effective prevention and/or primary intervention to avoid problems with health and well-being of individuals requires developing an awareness and understanding of the areas necessary for improvement (e.g. concerning diet or lifestyle) and the inherent motivation for individuals to change their current lifestyle/habits. The former requirement can be addressed by having suitably constructed feedback and information sources to guide individuals, and the latter requirement requires developing an understanding of the individual's underlying needs (as discussed in Maslow A., Toward a psychology of being, 1968, New York, Van Nostrand Reinhold; and Maslow A. H., Motivation and personality, 1970, New York, Harper & Row). For example, a person's underlying needs can be assessed by measuring the individual's basic needs satisfaction inventory to decide the best approach for changes to that particular individual's lifestyle at that point in time. Self-monitoring and self-intervention to prevent disease has been practiced to varying degrees with limited success, and the utility of such methods is becoming less effective because the methods are not personalized to the level required for effective behavioural change.
One of the benefits of large investments in public health, as well as the broad-based community treatment of conditions such as metabolic and cardiovascular diseases, is the greater knowledge and understanding of pre-disease states of the body and mind that acts as a warning sign and impetus to the need for a lifestyle change in order to maintain health and well-being in an individual (as discussed in Stone D. H., Public health in the undergraduate medical curriculum—can we achieve integration?, J. Eval. Clin. Prac., 2000 6(1), pp. 9-14). However, modern healthcare has evolved into a complicated morass of multiple professions providing a range of specialised services delivered by an increasingly bureaucratic system of administration. The disproportionate lack of emphasis on broad-based public health initiatives and the inability of individuals to proactively monitor their health and well-being has contributed to an impending global expansion in the incidence of preventable metabolic, cardiovascular and mental disease conditions (as discussed in Lackland D. T., Systemic hypertension: an endemic, epidemic and a pandemic, Semin. Nephrol., 2005, 25(4), pp. 194-7). A large unmet need exists for effective primary prevention and/or primary intervention that are based upon health-promoting self-care in the home. Health-promoting self-care is a way for people to take control of their health (as discussed in Haug M. R., Wykle M. L., Namazi K. H., Self-care among older adults, Soc. Sci. Med., 1989, 29, pp. 171-83.) and is a strategy for attaining national health goals (as discussed in Pender N. J., 1996, Health promotion in nursing practice, 3rd Ed., Stamford Conn., Appleton & Lange). Persons who are more fulfilled and content with themselves and their lives, have physical need satisfaction, and have positive connections with others may be able to make better decisions regarding positive health-promoting self-care behaviours (as discussed in Acton G. J., Malathum P., Basic Need Status and Health-Promoting Self-Care Behaviour in Adults, Western J. Nurs. Res., 2000, 22(7), pp. 796-811).
Healthcare professionals such as doctors and pharmacists have traditionally provided face-to-face counseling to individual patients regarding clinical medicine, disease management and related primary healthcare issues. Developments in electronic technology led to the introduction of a range of services that could provide information and feedback to the healthcare professional or patient in an automated and remote manner. The vast majority of such systems are dedicated to improving the management of existing disease states (i.e. disease management) using disease monitoring systems, managing electronic medical record management systems and automating diagnosis of diseases. These systems do not provide preventive healthcare interventions that can motivate a user to prevent a disease and maintain acceptable health and well-being.
For example, U.S. Pat. No. 6,648,820 to Sarel discloses a medical condition sensing system for home monitoring. Sarel discloses the use of remote sensing of a medical condition such as an acute cardiovascular condition and a point scoring system to signify risk levels associated with the medical condition.
U.S. Pat. No. 6,322,504 to Kirshner discloses a computerized interactive method and system for determining a risk of developing a disease and its consequences. Kirshner discloses a method of computerized interaction with the remote user to provide disease risk management. Others have also described further automated methods for: monitoring asthmatic patients as disclosed in U.S. Pat. No. 6,612,985 to Eiffert and Schwartz; monitoring diabetic patients as disclosed in US Patent Publication 2001/0037060 (application Ser. No. 09/778,249) to Thompson and Rubsamen; automatically optimizing a disease therapy as disclosed in U.S. Pat. No. 6,234,964 to Iliff; and identifying at-risk individuals using available existing disease care management data (prescription drug data, clinical lab data, claims data and in-patient information) to avoid high-cost medical events as disclosed in U.S. Pat. No. 6,802,810 to Ciarniello et al.
Others have sought to address the need to provide feedback systems that can motivate a user to improve a current health condition but again these systems do not provide preventive healthcare interventions that can motivate a user to prevent a disease and maintain acceptable health and well-being. For example, U.S. Pat. No. 5,879,163 to Brown and Jensen discloses an on-line health education and feedback system that queries a user's motivational drivers in an attempt to provide customized educational material to the user based on their comprehension, information format preferences and current health condition. Brown and Jensen disclose a method for providing targeted health information to a user to improve the management of a current health condition.
Others have sought to address the need to motivate a user to prevent disease and improve wellness or well-being. These systems provide general feedback on improving risk items associated with physical health condition but do not provide feedback on mental health condition beyond arbitrary scores of mental health that are of limited clinical utility.
For example, U.S. Pat. No. 5,692,501 to Minturn discloses a computer printed form for providing 10-point health/fitness/wellness scales for comparing actual against ideal wellness accompanied by a financial (insurance) incentive feature. Minturn discloses preparing a personal analysis for an individual and providing an assessment of excellent, good, average, poor or dangerous well-being with recommendations for gentle aerobic exercising.
U.S. Pat. No. 5,937,387 to Summerell et al. discloses a system and method for developing and selecting a customized wellness plan for measuring a user's wellness by determining a user's physiological age. Summernell et al. discloses an interactive system for allowing the user to determine the effects of various lifestyle changes or habits (e.g., weight loss, smoking cessation) on the user's physiological age.
U.S. Pat. No. 6,725,209 to Iliff discloses a computerized medical diagnostic and treatment advice system for mental status examination to monitor the level of consciousness in a patient at risk of an acute medical condition.
It is desired to address the deficiencies in the above or at least provide a useful alternative.